Common Aeroallergens Research Articles

Airway macrophage glycolysis controls lung homeostasis and responses to aeroallergen.

The lungs represent a dynamic microenvironment where airway macrophages (AMs) are the major lung-resident macrophages. AMs dictate the balance between tissue homeostasis and immune activation and thus have contradictory functions by maintaining tolerance and tissue homeostasis, as well as initiating strong inflammatory responses. Emerging evidence has highlighted the connection between macrophage function and cellular metabolism. However, the functional importance of these processes in tissue-resident specialized macrophage populations such as those found in the airways, remain poorly elucidated. Here, we reveal that glycolysis is a fundamental pathway in AMs which regulates both lung homeostasis and responses to inhaled allergen. Using macrophage specific targeting in vivo, and multi-omics approaches, we determined that glycolytic activity in AMs is necessary to restrain type 2 (T2) immunity during homeostasis. Exposure to a range of common aeroallergens, including house dust mite (HDM), drove AM-glycolysis and furthermore, AM-specific inhibition of glycolysis altered inflammation in the airways and HDM-driven airway metabolic adaptations in vivo. Additionally, allergen sensitised asthmatics had profound metabolic changes in the airways, compared to non-sensitised asthmatic controls. Finally, we found that allergen driven AM-glycolysis in mice was TLR2 dependent. Thus, our findings demonstrate a direct relationship between glycolysis in AMs, AM-mediated homeostatic processes, and T2 immune responses in the lungs. These data suggest that glycolysis is essential for the plasticity of AMs. Depending on the immunological context, AM-glycolysis is required to exert homeostatic activity but once activated by allergen, AM-glycolysis influences inflammatory responses. Thus, precise modulation of glycolytic activity in AMs is essential for preserving lung homeostasis and regulating airway inflammation.

Clinical and molecular analysis of longitudinal rhinitis phenotypes in an urban birth cohort

BackgroundChronic rhinitis symptoms cause significant health burden among children and can have a heterogeneous presentation. Defining phenotypes of childhood chronic rhinitis and associated pathobiology may lead to prevention or improved treatments. ObjectivesTo identify longitudinal patterns of rhinitis symptoms in childhood and determine their associations with early life risk factors, allergic comorbidities, and nasal epithelial cell gene expression. MethodsChronic rhinitis symptoms were evaluated from ages 1 through 11 years in 485 urban children at high risk for allergic disease in the Urban Environment and Childhood Asthma (URECA) birth cohort. We identified longitudinal rhinitis phenotypes and their relationships to early life exposures, atopic comorbidities, and patterns of nasal epithelial gene expression at age 11 years. ResultsChronic rhinitis symptoms started early in many children and were a risk factor for developing aeroallergen sensitization. We identified four longitudinal rhinitis phenotypes: low/minimal disease, persistent, persistent decreasing, and late increasing. Persistent rhinitis was most closely linked to allergic sensitization and asthma. Risk factors for persistent rhinitis included frequent colds (p<0.001), antibiotic use (p<0.001), and reduced exposure to common indoor aeroallergens (p=0.003). Compared to low/minimal disease, rhinitis phenotypes were associated with increased expression of canonical Type 2 genes and decreased expression of immune response genes. ConclusionsIn urban children, rhinitis symptoms often precede aeroallergen sensitization. Rhinitis phenotypes based on symptoms had distinct risk factors and nasal transcriptome. These results suggest that focusing on early life risk factors and distinct immune mechanisms may be a target to preventing chronic rhinitis in childhood.

Work-Related Symptoms of Spice Shop Workers and the Effect of Common Aeroallergen Sensitivity on Work-Related Symptoms

Work-Related Symptoms of Spice Shop Workers and the Effect of Common Aeroallergen Sensitivity on Work-Related Symptoms

Impact of wheat sensitization on wheeze and T2 phenotypes in general population of children

BackgroundThe association between sensitization to specific aeroallergens and outcomes in patients with asthma is well-researched; however, the association between childhood-onset wheeze/asthma and sensitization to various aeroallergens and food allergens in the general pediatric population remains poorly understood. ObjectiveThe association between sensitization to common aeroallergens and food allergens with wheeze and type 2 (T2) inflammation in the general pediatric population was investigated. MethodsSpecific IgEs against nine aeroallergens and four food allergens were measured in the prospective Hokkaido birth cohort of 428 school-age children (approximately 10 years of age). Wheeze and other allergic symptoms were assessed using the International Study of Asthma and Allergies in Childhood questionnaire. Blood eosinophil count and fractional exhaled nitric oxide level were assessed as T2 biomarkers. The Isle of Wight (IOW) birth cohort in UK was used for replication analysis (n=1032). ResultsThe prevalence of sensitization to at least one aeroallergen and food allergen was 70.5% and 22.3%, respectively. A significant association between wheeze and sensitization to aeroallergens such as ragweed, Japanese cedar, mugwort, and pet dander, were found. However, the association between wheeze and wheat sensitization was highly significant (Hokkaido birth cohort, odds ratio [OR]: 4.67; 95% confidence interval [CI]: 1.98–11.01; IOW birth cohort, OR: 4.01, 95% CI: 1.78–9.07). Sensitization to most aeroallergens, though not any food allergens, was associated with the T2high phenotype. ConclusionSensitization to wheat may be an important risk factor for wheeze/asthma development, especially the pathogenesis of T2-non/low asthma, independent of aeroallergens, in the general pediatric population.

Work-Related Symptoms of Spice Shop Workers and the Effect of Common Aeroallergen Sensitivity on Work-Related Symptoms.

Spices, because of their bioactive content, can cause irritation and allergic symptoms in the respiratory system and skin. Spice shop workers are constantly exposed to spices and dried herbs as part of their jobs. This study aimed to investigate the work-related symptoms of spice shop workers. Another aim was to assess the risk status of having an atopic nature for work-related symptoms. This was a cross-sectional study. Our research team visited the spice shops and a questionnaire was administered to 112 workers to assess work-related symptoms. In order to determine atopy, 79 of them had skin prick tests with common aeroallergens. Workers had eye complaints (19.6%), runny noses (22.3%), skin symptoms (9.8%), shortness of breath (9.8%), and coughs (19.6%) at work. The prevalence of atopy was 18%. Atopy was associated with work-related eye complaints (odds ratio (OR): 4.12, 95% CI: 1.17-14.46), work-related runny nose, and work-related cough (OR: 4.85, 95% CI: 1.44-16.32, and OR: 4.41, 95% CI: 1.30-14.97). The workers in spice shops are adversely affected by spices and dried herbs in their working environment. Being sensitive to common aeroallergens poses a risk for occupational symptoms.

Sensitization to Food and Aero-Allergens in Children with Coeliac Disease Assessed with the Use of a Multiplex Molecular Diagnostic Technique

(1) Background. Coeliac disease (CD) often co-occurs with autoimmune conditions or genetic syndromes, but there are few studies on the co-existence of CD and immunoglobulin E (IgE)-mediated allergies. The purpose of this study was to assess sensitization to food and aero-allergens in pediatric patients with CD. (2) Methods. A multiplex ALEX®2 test was used to determine specific IgEs (sIgEs). (3) Results. The study included 108 children newly diagnosed with CD. Allergen extract- and/or allergen molecule-sIgEs were detected in 49.1% of children. Most children (41.5%) were sensitized to both inhalant and food allergens. The three most common aero-allergens (timothy pollen, ryegrass, silver birch) were molecules Phl p 1, Lol p 1, and Bet v 1. The most common food allergens (hazelnut, apple, and peanut) were Cor a 1, Mal d 1, and Ara h 8 molecules of the PR-10 subfamily. Patients were not sensitized to cereal allergens containing gluten. Spearman’s rank correlation analysis of sensitized patients showed a significant positive relationship (r = 0.31) between the patients’ age and the occurrence of positive sIgEs (≥0.3 kUA/L) for inhalant allergen molecules (p = 0.045). In sensitized patients, mainly symptoms of inhalant allergy were observed, such as hay fever, conjunctivitis, and bronchial asthma. (4) Conclusions. The current study indicates the co-occurrence of IgE sensitization to food and inhalant allergens in children with CD. The study highlights the need to take a closer look at the diagnosis of IgE-mediated allergy in patients with CD, which may help in their care and lead to a better understanding of the relationship between CD and IgE-mediated allergy.

Factors associated with sensitisation to selected aero-allergens in children and adolescents with asthma followed up at Laquintinie Hospital Douala, Cameroon.

In spite of the substantial impact of pediatric asthma on healthcare resources, there is a notable dearth of research focusing on allergen sensitization specifically in children and adolescents with asthma in Cameroon, with existing studies primarily concentrating on adult populations. We, therefore, set out to determine factors associated with sensitization to selected aero-allergens in children and adolescents with asthma followed up at Laquintinie Hospital Douala, Cameroon. We conducted a cross-sectional analytical study on patients aged 2-17 years followed up for pediatric asthma at Laquintinie Hospital Douala for 8 months (January to August 2023). Skin prick tests were performed using selected standardized aeroallergens extracts. Factors associated with sensitization were determined using multivariable logistic regression analysis. The threshold for significance was set at p < .05. In total, 126 children and adolescents with asthma were recruited, 50.79% of whom were male with an average age of 8.00 ± 3.99 years. Eight out of 10 patients (83.52%) were sensitized to common aero-allergens (20.59% monosensitized and 79.41% polysensitized). The most common aero-allergens found were the dust mites Dermatophagoïdes pteronyssinus (81.37%), Blomia tropicalis (67.64%) and Dermatophagoïdes farinae (52.94%) followed by Blatella species (25.49%). The factors independently associated with sensitization in our population were the personal history of allergic rhinitis in the patient [adjusted odds ratio, aOR: 4.07 (95% confidence interval, CI: 1.41-11.76), b = 0.54, p = .009], chest tightness at rest [aOR: 5.92 (95% CI: 1.08-32.38), b = 0.87, p = .040), and age above 5 years [aOR: 4.65 (95% CI: 1.47-14.69), b = 0.59, p = .009). Sensitization to multiple aeroallergens is common in children and adolescents with asthma, especially for dust mites and cockroaches. Factors associated with sensitization are patients aged >5 years, chest tightness at rest, and a personal history of allergic rhinitis.

Pattern of aeroallergen sensitivity in bronchial asthma patients: A cross-sectional study in a tertiary care centre

Abstract INTRODUCTION: Asthma is one of the most common chronic noncommunicable diseases. Aeroallergens are often implicated in the pathogenesis of allergic rhinitis (AR) and bronchial asthma (BA). Identification of the most prevalent aeroallergens, to which the patients are sensitized, plays an important role in the diagnosis and treatment of BA. Among various diagnostic tests for detecting sensitizing allergens, the skin prick test (SPT) is a useful method to demonstrate hypersensitivity to a specific antigen. METHODOLOGY: This was a hospital-based cross-sectional observational study carried out on BA patients attending our institute during the year 2020–2021. BA patients of both sex and age between 18 and 65 years, diagnosed according to the latest GINA guidelines and gave written informed consent were included in the study. After recruitment, the participant’s detailed medical history and sociodemographic data were obtained. Total eosinophil count (TEC), serum immunoglobulin E (S. IgE), X-ray PNS, chest X-ray, and other investigations as required were done. SPT was done using 63 antigens, which included 20 pollens, 8 fungi, 5 insects, 8 dusts, 4 dander, 2 dust mites, 2 feathers, and 14 food allergens. RESULTS: Six thousand and three hundred SPTs were performed with a total of 63 allergens using the modified SPT technique. Of the 100 patients enrolled, 71% were diagnosed as BA and 29% as BA with AR. Among the study population, 44% were females and 56% were males. The majority was constituted of young adults, aged 21–30 years. More than half of the patients (68%) had their duration of disease between 1 and 5 years. Seventy percent patients reported seasonal variation in symptoms, and spring season was associated with maximum allergic exacerbations followed by winter. Significant positive reaction (≥2+) in SPT was found in 89% of patients, whereas 11% tested negative for all allergens. pollens were the most common aeroallergen group identified, whereas feathers and food allergens were the least common in the present study. Among pollen, Prosopis juliflora was the most common (24%) pollen-causing sensitization closely followed by Holoptelea integrifolia (17%) and Gynandropsis gynandra (18%). Female cockroach (37%) and mosquito (37%) were the most common insects to which the majority of the population were sensitized. Dermatophagoides farinae was accounting for 23% of positive reactions in the study population. Alternaria tenuis was the most common fungus to which 6% of the patients tested positive. House dust (17%) was the most common dust subgroup associated with positive SPT. Among danders, buffalo dander (8%) was observed to be the most common sensitizer followed by dog dander (6%). The pigeon feather was the most common feather identified. A strong positive correlation was observed between S. IgE and the number of allergens that tested positive (r = 0.489; P &lt; 0.0001) and a strong positive correlation was observed between serum TEC and the number of allergens that tested positive (r = 0.430; P &lt; 0.0001). CONCLUSION: Our study identified pollen as the most common sensitizing aeroallergen followed by insects. Such studies, conducted from time to time, shed light on the changing trends of the commonly prevalent allergens in a particular area. The identification of offending allergens for a patient also explores treatment options such as allergen-specific immunotherapy.

Exposure to air pollution concentrations of various intensities in early life and allergic sensitisation later in childhood

BackgroundEvidence on the relationship between air pollution and allergic sensitisation in childhood is inconsistent, and this relationship has not been investigated in the context of smoke events that are predicted to increase with climate change. Thus, we aimed to evaluate associations between exposure in two early life periods to severe levels of particulate matter with an aerodynamic diameter < 2.5 μm (PM2.5) from a mine fire, background PM2.5, and allergic sensitisation later in childhood.MethodsWe measured specific immunoglobulin E (IgE) levels for seven common aeroallergens as well as total IgE levels in a cohort of children who had been exposed to the Hazelwood coal mine fire, either in utero or during their first two years of life, in a regional area of Australia where ambient levels of PM2.5 are generally low. We estimated personal exposure to fire-specific emissions of PM2.5 based on a high-resolution meteorological and pollutant dispersion model and detailed reported movements of pregnant mothers and young children during the fire. We also estimated the usual background exposure to PM2.5 at the residential address at birth using a national satellite-based land-use regression model. Associations between both sources of PM2.5 and sensitisation to dust, cat, fungi, and grass seven years after the fire were estimated with logistic regression, while associations with total IgE levels were estimated with linear regression.ResultsNo association was found between the levels of exposure at either developmental stage to fire-related PM2.5 and allergic sensitisation seven years after the event. However, levels of background exposure were positively associated with sensitisation to dust (OR = 1.90, 95%CI = 1.12,3.21 per 1 μg/m3).ConclusionsChronic but low exposure to PM2.5 in early life could be more strongly associated with allergic sensitisation in childhood than time-limited high exposure levels, such as the ones experienced during landscape fires.

Spectrum of sensitization to aeroallergens as one of the risk factors for uncontrolled severe asthma

BACKGROUND: Asthma is considered one of the urgent medical and social problems of the XXI century. In recent years, not only an increase in the incidence, but also an increase in the prevalence of severe forms of asthma has been noted in all countries of the world. The effect of the sensitization spectrum on the severity and level of asthma control has not been studied enough.&#x0D; AIM: Evaluate the importance of sensitization spectrum to aeroallergens in severe asthma patients as indicators for disease exacerbation risk.&#x0D; MATERIALS AND METHODS: Single-center cross-sectional study at North-Western State Medical University n.a. I.I. Mechnikov. Examined 93 severe asthma patients. Analysis covered demographic traits, comorbidities, hereditary history, living conditions, exacerbations, past-year hospitalizations, medications, spirometry, and specific IgE presence for 10 aeroallergens.&#x0D; RESULTS: Aspergillus fumigatus specific IgE notably impacted asthma control. Disease exacerbation risk was 8.4 times higher with A. fumigatus sensitization. Multivariate logistic regression revealed higher risk with A. fumigatus sensitization (4.79), fixed obstruction (6.2), systemic steroids use (5.85), indoor mold exposure (4.45), and familial asthma history (2.53).&#x0D; CONCLUSION: A. fumigatus sensitization significantly influences asthma course and control, worsening prognosis. Targeted examination of patients measuring sIgE levels for common aeroallergens is necessary to identify control obstacles. The results of the study were previously reported at the All-Russian Congress on Medical Microbiology, Clinical Mycology and Immunology and published in the form of abstracts in the journal Problems in medical mycology, 2022, Vol. 24, No 2.

Clinical factors influencing olfactory performance in patients with persistent COVID-19 smell loss longer than 1 year.

Factors affecting persistence of COVID-19-related olfactory dysfunction (OD) remain partially unknown. We aim to evaluate the clinical factors which could influence olfactory performance in patients with persistent COVID-19-related smell loss. A retrospective analysis of 100 patients with persistent COVID-19-related OD was performed between October 2020 and December 2022 at a single-center long-COVID smell clinic. All subjects underwent smell assessment using Sniffin' Sticks (S'S) extended test, nasal endoscopy, nasal airflow evaluation (peak nasal inspiratory flow [PNIF]), allergy test (skin prick test [SPT]) for common aeroallergens, MRI of the head and patient-reported outcome measures (PROMs-VAS, SF-36, Short QOD-NS, SNOT-22). Based on S'S score, subjects were divided into normosmics (TDI ≥ 30.75) and dysosmics (TDI < 30.75). The median age was 42 years and the median length of patient-reported OD was 1.4 years. 20 patients (20.0%) were normosmic at the time of S'S assessment. Dysosmic patients were found to have significantly lower scores at the SF-36 health domains for energy/fatigue (p = .0004) and emotional wellbeing (p = .04) when compared to normosmics. A moderate correlation (r = .45-.59) between S'S scores and some PROMs was also demonstrated. At the multivariate analysis higher PNIF scores positively influenced odor threshold (p = .001) while positivity to SPT negatively influenced odor identification (p = .04). Impairment of nasal airflow and sensitivity to aeroallergens can negatively affect olfactory performance in COVID-19-related OD. Long-COVID smell loss deeply affects QoL although recovery of olfaction can bring it back to a normal range. IV.

Atopic dermatitis associated with tropical endemic limbo-conjunctivitis: Epidemiology, clinical phenotypes, and allergological investigations

Background: Atopic dermatitis (AD) is on the increase worldwide. In Africa, 40% of cases are associated with tropical endemic limbo-conjunctivitis (TELC). Its predominance in early childhood has a major impact on the quality of life of children and their parents, leading to absenteeism from school and work. The aim of this study was to assess the particularities of AD associated with TELC in Dakar. Materials and Methods: This was a cross-sectional, multicenter study with prospective data collection over a six-month period, conducted at dermatology and ophthalmology departments in Dakar. All patients treated for atopic dermatitis with or without TELC were included in the study. Data entry and analysis were performed with SPSS 18. Results: From the study, 97 cases of atopic dermatitis were identified. Among these, 49 had AD associated with TELC. The sex ratio was 1.18 (36 boys and 13 girls). The mean age of patients was ten years. The age range between 5 and 10 years was more represented. There was atopy equivalent to allergic rhinitis in 44 cases, asthma in 16 cases, allergic conjunctivitis in 14 cases, and food allergy in 20 cases. 31 cases of AD were mild, 16 moderate, and 2 severe according to SCORAD. Patients were in stage I in 26 cases and in stage II in 13 cases according to Diallo’s TECL classification. All patients were managed by dermatologists and ophthalmologists. Aeroallergen prick tests were performed in thirty cases. Tests were positive for house dust mites in 23 cases (92%), animal dander in 11 cases (44%), molds in 7 cases (28%), and pollens in 2 cases (8%). Dermatophagoides pteronyssinus and farinae were the most common aeroallergens. Patch tests were positive for potassium dichromate in 4 cases, cobalt in 4 cases, nickel in 3 cases, and lanolin in 4 cases. Conclusion: AD associated with TECL remains common in tropical environments. They share common aggravating environmental factors, notably hypersensitivity to aeroallergens and a predominance in early childhood. The major impact on functional prognosis makes therapeutic education and multidisciplinary management of patients essential. Key words: Atopic dermatitis, Tropical limbo-conjunctivitis, Dakar

Asthmatics only sensitized to Staphylococcus aureus enterotoxins have more exacerbations, airflow limitation, and higher levels of sputum IL-5 and IgE.

Staphylococcus aureus Enterotoxins (SE) may act as superantigens and induce an intense T cell activation causing local production of polyclonal IgE and resultant eosinophil activation. To assess whether asthma with sensitization to SE but not to common aero-allergens (AA) displays different inflammatory characteristics. We conducted a prospective study on a series of 110 consecutive patients with asthma recruited from the University Asthma Clinic of Liege. We compared clinical, functional and inflammatory characteristics of this general population of asthmatics categorized in 4 groups according to sensitization to AA and/or SE. We also compared sputum supernatant cytokines in patients sensitized to SE or not. Asthmatics only sensitized to AA represented 30%, while 29% were sensitized to both AA and SE. One fifth of the population had no specific IgE. Sensitization to SE but not to AA (21%) was associated with later onset of disease, higher rate of exacerbations, nasal polyps and more severe airway obstruction. As for airway type-2 biomarkers, patients presenting with specific IgE against SE (SE-IgE) displayed higher FeNO, sputum IgE and sputum IL-5 levels but not IL-4. We confirm that the presence of SE-IgE is associated with elevated serum IgE to levels well above those observed in patients only sensitized to AA. Our study suggests that asthma specialists should measure SE-IgE during the phenotyping process as it may allow the identification of a subgroup of patients with more asthma exacerbations, more nasal polyposis and chronic sinusitis, lower lung function and more intense type-2 inflammation.

The distribution of sensitization to common aeroallergens in patients with rhinitis and asthma in Şanlıurfa, Türkiye.

Sensitization to common environmental aeroallergens plays a significant role in the pathogenesis and severity of asthma and allergic rhinitis. Knowledge on the sensitization pattern helps allergen avoidance, prediction of the severity of the disease, and use of specific immunotherapy for the most common allergens. The distribution of sensitization to aeroallergens differs in every region of Türkiye. In this study, it was aimed to investigate the allergen sensitization profiles of patients with asthma and rhinitis in Şanlıurfa, which is in Southeast Türkiye. Patients with rhinitis and asthma who presented to the outpatient clinic of adult immunology and allergy between April 2021- 2022 were retrospectively evaluated. Demographic information (age, sex), rhinitis and asthma duration, location of residence, allergic and non-allergic comorbidities, smoking history and skin prick test results were extracted from medical records. A total of 472 skin prick tests were performed on patients (35.4% males; 64.6% females), with a mean age of 33.8 years, and 120 (25.4%) were negative for skin reaction. The frequency of sensitivity to allergens was: grass (42.6%), cereal mixtures (41.5%), timothy grass (37.9%), cockroach (37.3%), olive tree (35%), house dust mites (Dermatophagoides farinae 27.5%, Dermatophagoides pteronyssinus 20.8%). In patients with only rhinitis (n= 305), the most frequent aeroallergen was pollen (grasses 43.6%; cereal mixtures 43.3%; timothy grass 41.6%; olive pollen 37.4%). In patients with asthma and rhinitis (n= 134), the most frequent aeroallergen was grass (44.8%). In patients with only asthma (n= 33), the most frequent aeroallergens were D. farinae (27.3%) and cockroach (27.3%). The most frequently detected allergens in this study were pollen, cockroach, and house dust mites, respectively. The findings revealed that pollen was the most frequent aeroallergen in subjects with allergic rhinitis with and without asthma. In patients with only asthma, the most frequent aeroallergen was house dust mites.

Birth order, sibship size, and risk of atopic dermatitis, food allergy, and atopy: A systematic review and meta‐analysis

AbstractBackgroundAtopic dermatitis and food allergy are two frequently concomitant manifestations of the presence of atopy. A substantial number of studies have been published on the association of birth order and sibship size (number of siblings) with atopic dermatitis, food allergy, and atopy. The present work is the first systematic synthesis of the existing literature on this topic.MethodsFifteen databases were searched. Screening, data extraction, and quality assessment were performed by independent pairs. Comparable numerical data were statistically synthesized using random‐effects robust variance estimation.ResultsIn total, 114 studies were included out of 8819 papers obtained from database searches. Birth order ≥2 versus 1 was associated with lower risk of ever atopic dermatitis (pooled risk ratio [RR] 0.91, 95% CI 0.84–0.98), current food allergy (RR 0.77, 95% CI 0.66–0.90), and positive skin prick test (SPT) to common aeroallergens (RR 0.86, 95% CI 0.77–0.97). Sibship size ≥2 versus 1 was associated with decreased risk of current atopic dermatitis (RR 0.90, 95% CI 0.83–0.98), ever atopic dermatitis (RR 0.92, 95% CI 0.86–0.97), and positive SPT to common aeroallergens (RR 0.88, 95% CI 0.83–0.92). No putative associations were seen regarding atopy assessed through allergen‐specific immunoglobulin E with common allergens.ConclusionThe presence of siblings and being second‐born or later may decrease the lifetime risk of atopic dermatitis and food allergy, albeit marginally. Similar association was seen with SPT sensitization. However, significant protection was not found for IgE sensitization.

The Diagnostic Value of Delayed-Type Reactions to Perennial Aeroallergens for Atopic Disease.

Background: Delayed-type reactions to aeroallergens have been observed, however, their clinical significance continues to be debated. Objective: We assessed the prevalence and significance of delayed-type reactions to aeroallergens in atopic patients. Methods: Retrospective study including 266 patients with history or evidence of atopic disease (atopic dermatitis [AD], allergic rhinitis, and/or allergic asthma) and tested via either the intradermal skin test (IDT) or atopy patch test for common aeroallergens, specifically house dust mites (Dermatophagoides farinae, Dermatophagoides pteronyssinus) and perennial molds (Aspergillus fumigatus, Penicillium notatum). All patients were tested via IDT with both immediate (15 minute) and delayed (2 and 4 days) readings. Delayed reading was considered positive if the IDT injection site demonstrated at least 5 mm induration 48 hours after inoculation. Results: In total, 195 (73.3%) patients demonstrated an immediate-type reaction, whereas 118 (44.4%) had a delayed-type reaction. In total, 75 (28.2%) patients experienced both immediate- and delayed-type reactions, 43 (16.2%) reacted delayed-type only, and 85.3% of delayed-type reactions to individual aeroallergens were associated with eczematous lesions predominantly in air-exposed areas. Conclusion: Delayed-type reactions to aeroallergens are prevalent and clinically significant as a component of extrinsic AD and atopic diseases. The data support delayed reading of the IDT to guide diagnosis and management in these patients.

EVALUATION OF SKIN PRICK TEST FOR COMMON AERO ALLERGENS IN PATIENTS WITH BRONCHIAL ASTHMA

Background and Objective: Aeroallergens play a signicant role in the aetiology of asthma and other allergic respiratory disorders. Evaluation of skin prick test for common aeroallergens in bronchial asthma patients and identication of the function of different inhalant allergens in bronchial asthma patients were the goals of the study. A prospective observational st Methods: udy was conducted on the data acquired from patients with bronchial asthma who had pre-performed spirometry and were attending the Chest OPD of a tertiary hospital. The mean age of the study Results: group was 39.7 years. The skin prick test was positive to atleast one aeroallergen in 82.2%. The intensity of the SPT reaction was greatest for fungi and house dust mites in patients with bronchial asthma. The skin prick tes Conclusion: t has excellent sensitivity and specicity for detecting allergen-specic IgE, and in some instances is more sensitive than in-vitro testing for specic IgE in serum

House dust mite and Th2 cytokine-mediated epithelial barrier dysfunction attenuation by KL001 in 16-HBE cells

ABSTRACT House dust mite (HDM) is a common aeroallergen that can disrupt the airway epithelial barrier leading to dysregulated immune response, resulting in allergic lung diseases such as asthma. Cryptochrome (CRY), a circadian clock gene, plays an important role in the regulation of metabolism, and immune response. It remains unclear whether stabilizing CRY using KL001 can attenuate HDM/Th2 cytokine-induced epithelial barrier dysfunction in 16-HBE cells. We evaluate the effect of KL001 (20 µM) pre-treatment (4 hrs) in HDM/Th2 cytokine (IL-4 or IL-13)-mediated change in epithelial barrier function. HDM and Th2 cytokine-induced changes in transepithelial electrical resistance (TEER) were determined by an xCELLigence real-time cell analyzer and delocalization of adherens junction complex (AJC: E-cadherin and β-catenin) and tight junction proteins (TJP: Occludin and Zonula occludens-1) by immunostaining and confocal microscopy. Finally, quantitative real-time PCR (qRT-PCR) and Western blotting were used to measure altered gene expression and protein abundance of the epithelial barrier function and core clock genes, respectively. HDM and Th2 cytokine treatment significantly decreased TEER associated with altered gene expression and protein abundance of the selected epithelial barrier function and circadian clock genes. However, pre-treatment with KL001 attenuated HDM and Th2 cytokine-induced epithelial barrier dysfunction as early as 12–24 hrs. KL001 pre-treatment showed attenuation of HDM and Th2 cytokine-induced alteration in the localization and gene expression of AJP and TJP (Cdh1, Ocln, and Zo1) and core clock genes (Clock, Arntl/Bmal1, Cry1/2, Per1/2, Nr1d1/Rev-erbα, and Nfil3). We demonstrate, for the first time, the protective role of KL001 in HDM and Th2 cytokine-mediated epithelial barrier dysfunction.

Clinical features and risk factors of IgE-independent aтopic dermatitis in children

Relevance. Atopic dermatitis (AD) is an inflammatory disease characterized by a chronic course with periods of remissions and exacerbations. IgE-independent atopic dermatitis is a medical and social problem of our time, since the disease manifests itself most often in childhood and is one of the most frequent forms of dermatoses among the pediatric population. The prevalence of atopic dermatitis among children is up to 20 %, among adults - 2-8 %. Recently, there has been a significant increase in atopic diseases worldwide. The aim: to study specific features of IgE-independent atopic dermatitis in children living in a metropolis. Materials and Methods. A prospective cohort study was conducted, which included 451 children aged 5 to 14 years with a diagnosis of AD who applied for outpatient care at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology for the period 2020-2021. All parents (guardians) have given voluntary informed consent to the participation of children in the study and the publication of personal data. Examination of patients included general clinical methods, assessment of the SCORAD index and laboratory allergological examination (total and 73 specific IgE in blood serum with the most common food and aeroallergens). In 103 (22.8 %) children (57 (55.3 %) boys and 46 (44.7 %) girls), the results of the allergological analysis did not confirm concomitant allergic sensitization. Atopic dermatitis in these children was defined as IgE-independent. Results and Discussion. Predictors of the development of IgE-independent AD were hereditary predisposition [odds ratio (OR) 2.42; 95 % confidence interval (CI) 1.12-5.25], artificial feeding [OR 4.04; 95 % CI 1.46-11.20], comorbidities [OR 1.42; 95 % CI 0.57-3.52], late onset [OR 1.67; 95 % CI 0.81-3.41]. According to the SCORAD index, the majority of patients (75.7 %) had a moderate degree of AD and no seasonality. Features of skin rashes corresponded to the age periods of the course of AD: erythematous-squamous forms with lichenification foci prevailed. For the first time, the features of IgE-independent atopic dermatitis in children were shown. The role of risk factors for the development of IgE-independent atopic dermatitis in children has been shown for the first time. Conclusion. IgE-independent type of AD can be diagnosed in every fifth child with AD. The study of risk factors will allow predicting the development of this type of disease.

Prevelance of Common Aeroallergens in Allergic Rhinitis and its Correlation with Bronchial Asthma: A Study on 798 Patients by Skin Prick Test.

Allergic rhinitis affects 30% of the Indian population (Dey et al. in Int Arch Allergy Immunol 178:60-65, 2019). Patients can be sensitive to single or multiple allergens. Polysensitization is more common (Bousquet et al. in Ann Epidemiol 20:797-803, 2010; Arbes et al. in J Allergy Clin Immunol 116:377-383, 2005). Sensitization to multiple allergens may have a role in the severity and the association of Asthma in such patients. A total of 798 patients with allergic rhinitis (SFAR ≥ 7) were included. Disease severity and associated symptoms were evaluated using questionnaire. Each patient underwent a Skin prick test with an allergen panel of 35 allergens each (Annesi-Maesano et al. in Allergy 57:107-114, 2002) and the results were evaluated to study the association of asthma and severity of Allergic rhinitis. Data consisting of 389 (48.7%) males and 409 (51.3%) females were assessed. A total of 82.2% of the study population of symptomatic patients were sensitized to at least one of the allergens. Seventy patients (8.78%) had associated asthma. Forty-four patients were polysensitized and fifteen were mono sensitized. Among polysensitized patients, 36 patients had sensitization to at least 6 different allergens. Dermatophagoides pteronyssinus was the most common allergen among asthma patients. This study provides a thorough knowledge of locally prevalent aeroallergens which is essential for the prompt diagnosis and treatment of allergic patients. Skin prick test can be a non-invasive vital tool in analyzing patterns of allergen exposure, the prevalence of allergen, sensitizing potential of different allergens in that specific geographic area.